# Remote Resilience: Novel Applications of mHealth in Nicaragua's Cancer Control Program

> **NIH NIH R33** · UNIVERSITY OF VIRGINIA · 2024 · $282,477

## Abstract

PROJECT SUMMARY / ABSTRACT
Cervical cancer, a preventable cancer of disparities, is the primary cause of cancer death for women in
Nicaragua. The World Health Organization (WHO) adopted an elimination strategy for cervical cancer within the
next 100 years, and outlined specific targets to meet by 2030: vaccination (90% of girls before age 15);
screening/early detection (70% of women get a high-quality screen by 35 and again at 45); and treatment (90%
of pre-cancerous and cancerous lesions treated). As the majority of the burden of cervical cancer exists in low
and middle income countries (LMICs), significant research into the development, implementation, and cost-
effectiveness of community-based cervical cancer screening models using HPV primary screening has
developed a strong evidence-base for the acceptability and feasibility of this modality. However, significant
geographic variability exists in successfully improving patient health outcomes and preventing cervical cancer,
particularly in rural and remote geographic areas. In Nicaragua, significant intra-country variability exists in terms
of yearly participation in cervical cancer screening by eligible women, and likelihood of lifetime screening,
depending on geographic region. There is a demonstrated need for culturally-tailored, regionally specific
innovations in evidence-based HPV primary cervical screening programs. Based on a successful pilot study
enrolling nearly 2,000 women in Bluefields, Nicaragua, researchers have identified the unique role mHealth
(mobile health) interventions may play in improving health outcomes when integrated into an HPV primary
screening program. Innovations presented herein include the development of a mHealth platform that combines
a patient-centered mobile application (app) with a provider-focused portal, as well as integration of the provider-
focused portal with the National Cervical Cancer Surveillance System (SIVIPCAN). Through developing this
culturally-tailored, regionally appropriate mHealth intervention for women and healthcare providers (R21 phase)
and then pilot testing the impact of this intervention when integrated into a community-based HPV-based primary
cervical cancer screening program (R33 phase), this study will provide important evidence relative to the
potential for novel mHealth interventions to improve cervical cancer screening follow-up and treatment, with a
focus on rural and remote settings, often the hardest geographic regions in which to improve health outcomes.

## Key facts

- **NIH application ID:** 11078947
- **Project number:** 4R33TW012208-03
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** Juan Ramon Almendarez Peralta
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $282,477
- **Award type:** 4N
- **Project period:** 2022-08-12 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11078947

## Citation

> US National Institutes of Health, RePORTER application 11078947, Remote Resilience: Novel Applications of mHealth in Nicaragua's Cancer Control Program (4R33TW012208-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11078947. Licensed CC0.

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